title: Thrombosis in inflammatory bowel disease: are we tailoring prophylaxis to those most at risk?
abstract: Inflammatory bowel disease (IBD) is a disease-specific risk factor for incident and recurrent venous thromboembolism (VTE). The reasons are acquired, multifactorial, and related to prothrombotic aberrations during active disease, although the mechanisms remain incompletely elucidated. VTE represents a potentially life-threatening extraintestinal manifestation of IBD, but the associated morbidity and mortality can be reduced by appropriate use of thromboprophylaxis. Nevertheless, despite international guidelines advocating thromboprophylaxis in hospitalised patients with IBD, practice is highly variable, since 65% of gastroenterologists may not use pharmacological VTE prophylaxis in hospitalised patients with acute severe colitis. Furthermore, there is no guidance on appropriate prophylaxis for ambulatory outpatients with active disease who are at an appreciable risk of VTE. Thus the question: are we tailoring thromboprophylaxis to those patients with IBD who are most at risk?
authors.affiliation: Translational Gastroenterology Unit, John Radcliffe Hospital, Oxford University Hospitals NHS Trust, United Kingdom. Electronic address: Robert.Bryant@ouh.nhs.uk.
authors.forename: Robert V
authors.initials: RV
authors.lastname: Bryant
authors.affiliation: Translational Gastroenterology Unit, John Radcliffe Hospital, Oxford University Hospitals NHS Trust, United Kingdom; NHS Blood and Transplant, Oxford University Hospitals NHS Trust, United Kingdom. Electronic address: vipul.jairath@nhsbt.nhs.uk.
authors.forename: Vipul
authors.initials: V
authors.lastname: Jairath
authors.affiliation: Oxford Haemophilia and Thrombosis Centre, Churchill Hospital, Oxford University Hospitals NHS Trust, United Kingdom. Electronic address: Nicola.Curry@ouh.nhs.uk.
authors.forename: Nicola
authors.initials: N
authors.lastname: Curry
authors.affiliation: Translational Gastroenterology Unit, John Radcliffe Hospital, Oxford University Hospitals NHS Trust, United Kingdom. Electronic address: simon.travis@ndm.ox.ac.uk.
authors.forename: Simon P L
authors.initials: SP
authors.lastname: Travis
mesh_terms: D000925:Anticoagulants / Q000627:therapeutic use; D019983:Guideline Adherence; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000150:complications*; D062072:Patient Acuity; D018579:Patient Selection; D017410:Practice Guidelines as Topic; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D054556:Venous Thromboembolism / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*
chemical_list: D000925:Anticoagulants
keywords: Crohn's disease;; Inflammatory bowel disease;; Thrombosis;; Ulcerative colitis;; Venous thromboembolic disease